功能神经导航及术中磁共振成像在语言区胶质瘤手术中的应用

目的 探讨功能神经导航及高场强术中磁共振成像(iMRI)在脑语言区胶质瘤手术中的临床应用价值.方法 自2009年4月至2010年4月,48例语言区胶质瘤患者接受了功能神经导航及iMRI辅助下的手术.使用血氧水平依赖功能MRI(BOLD-fMRI)显示语言区皮层,同时采用弥散张量成像(DTI)技术重建弓形束,将上述语言功...

Functional neuro-navigation and intraoperative magnetic resonance imaging for the resection of gliomas involving eloquent language structures

Objectives To explore the clinical value of functional neuro-navigation and high-field-strength intraoperative magnetic resonance imaging(iMRI) for the resection of intracerebral gliomas involving eloquent language structures.Methods From April 2009 to April 2010, 48 patients with intracerebral gliomas involving eloquent language structures, were operated with functional neuro-navigation and iMRI.Blood oxygen level dependent functional MRI (BOLI-fMRI) was used to depict both Broca and Wernicke cortex, while diffusion tensor imaging ( DTI ) based fiber tracking was used to delineate arcuate fasciculus.The reconstructed language structures were integrated into a navigation system, so that intra-operative microscopic-based functional neuro-navigation could be achieved.iMRI was used to update the images for both language structures and residual tumors. All patients were evaluated for language function preoperatively and post-operatively upon short-term and long-term follow-up.Results In all patients, functional neuro-navigation and iMRI were successfully achieved.In 38 cases (79.2%), gross total resection was accomplished, while in the rest 10 cases (20.8% ), subtotal resection was achieved.Only 1 case (2.1% )developed long-term (more than 3 months ) new language function deficits at post-operative follow-up.No peri-operative mortality was recorded.Conclusions With functional neuro-navigation and iMRI, the eloquent structures for language can be precisely located, while the resection size can be accurately evaluated intra-operatively.This technique is safe and helpful for preservation of language function.